Warnings and Precautions Hypokalemia: B12 therapy may cause a drop in potassium levels (hypokalemia), particularly during early treatment in patients with significant B12 deficiency
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No serious adverse events were attributed to AOD 9604 in any trial
Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team
In pernicious anemia, parenteral vitamin B12 is needed long term, and monthly injections may be required for life
In animal studies, no observable adverse effects were reported, and the compound did not affect food intake or inhibit related enzymes